Provider Demographics
NPI:1043018559
Name:POOJA W BHARDWAJ DDS PLLC
Entity type:Organization
Organization Name:POOJA W BHARDWAJ DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:WALIA
Authorized Official - Last Name:BHARDWAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-951-2170
Mailing Address - Street 1:PO BOX 984
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-0984
Mailing Address - Country:US
Mailing Address - Phone:425-318-6073
Mailing Address - Fax:
Practice Address - Street 1:15321 MAIN ST NE STE 321
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-8574
Practice Address - Country:US
Practice Address - Phone:425-318-6073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty